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Policy and advocacy
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The world’s institutions have increasingly become dumping grounds for children with disabilities, including psychosocial disabilities. An abundance of evidence shows that these settings cause extensive physical and psychological harm. Low numbers of staff, lack of training, poor quality of care, harmful treatment practices, violence, abuse and overall neglect preclude any positive outcomes for children and as a result, many remain in institutional care for the rest of their lives, and many others die prematurely. 

This report underscores the urgent need for countries to move from institution-based care to community-based care. It provides guidance, based on promising practices from around the globe, on the key services and supports that need to be in place to ensure that children are able to live and thrive in the community. A firm commitment to redirecting investments towards community alternatives is critical, if we are to end these institutional abuses, and provide children with the best possible start at life.

Children and adolescents
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